Amanda was livid.  “Why wasn’t I called,” she demanded.

Dr. Wilson stood like a deer trapped in the onslaught of a pair of approaching headlights.  “I had everything under control.”

“Under control,” she repeated.  Her cheeks flared with anger.  “How in the hell did she get a hold of a pair of scissors!”

The man backed away from Amanda’s wrath.  “I don’t know, Dr. Blake.”

She sighed and sat down.  “You should be dismissed for neglect.”

Wilson’s ruddy complexion paled.  “What was I supposed to do?”

Amanda leaned towards him.  Her lips were set in a thin line.  “You’re lucky, Nicholas.  If I wasn’t so hard up for help I would fire you.  Nothing like this better happen again.”

Wilson swallowed.  As much as he hated the bitch, he knew she wouldn’t hesitate in destroying his professional career and God forbid if she ever learned of his molesting Samantha.  “Yes, Dr. Blake.”

“You’re dismissed.”

Amanda counted to ten then punched the top of her desk.  She had been appalled when she had gone into Samantha’s room and found her heavily sedated and strapped to the bed.  Normally, Samantha was docile and harmlessly roamed the short hallway.  If she wandered into an area she wasn't allowed, the mere mention of her name made her turn and go back towards her room.  Something had triggered her, yet it would still be a few hours before Nurse Horscham started her shift and that was who Amanda wanted to speak to.  In the meantime, she called Daniel to let him know something unexpected had come up and she’d be home when she was done.

She got up, lowered the blinds, and drew the dark brown curtains across the large window overlooking a sprawling section of lawn which was overrun by dead weeds and small bramble bushes that had taken root a couple of years ago.  She paused a moment behind the closed curtains thinking it would be a good spot to start the garden and to transfer the plants they had managed to grow indoors during the winter.  She figured the best way to clear the land would be by making a square trench around the area they would use and setting a fire at both ends to clear it.

Amanda’s head was pounding as she turned off the light.  The room was thrown into deep shadows which only emphasized the dark paneling.  She walked back to her desk and turned on a small lamp.  It cast a soft glow over Samantha’s medical records.  Until he had retired, she had been Dr. Thompson’s patient and had been fairing as well as could be expected.  Now, Dr. Wilson was in charge of her case.

Amanda pressed her fingers against her throbbing temples, hoping the pain would subside.  When it didn’t work as fast as she expected, she opened her desk drawer and took out a bottle of Anacin.  She shook out four, popped them in her mouth, and crunched them into small pieces before storing the bitter mass under her tongue.  The taste made her grimace but it was the quickest way to get the painkillers into her bloodstream.  As they began to take effect, she opened the thick folder and began to read.

Time flew by as she compared Dr. Thompson’s copious notes which showed encouragement.  She had been progressing in his sessions.  Dr. Wilson’s observations were clipped, bordering frustration about an uncooperative patient who was reticent in his presence.  She frowned wondering if the sudden change in doctors was the contributing factor.  Yet it didn’t make sense since Dr. Thompson had told her for over a month he was getting ready to retire and she would be talking to someone else.  He had been clear in his explanation, making sure she understood as they counted down the days together.  She also saw he had prescribed her lithium and chewed her lower lip as she noted the change in dose.  On the days when it was higher, Dr. Thompson had been trying to get her to talk to him about her childhood.  Not that she figured it would matter because Samantha rarely spoke more than five sentences a week and most of her responses were monosyllabic.

A knock on the door caused her to look up.  “Yes?”

The voice on the other side was hesitant.  “It’s Nurse Horscham, Dr. Blake.  You wanted to see me.”

Amanda relaxed.  “Yes, Pamela.  Please come in.”

Pamela was surprised Dr. Blake knew her first name.  Amanda’s name instilled fear among her, Nurse Matthews, and Dr. Wilson before she even became medical director less than a year ago.  “Close the door and sit down.”

The nurse felt like a dog as she obeyed Dr. Blake’s curt request and crossed the beige carpet to her desk where she pulled out a chair and sat down.  “It’s chilly out there.”

“Yes,” Amanda said with a wave of her hand as if to dismiss the other woman’s attempt at pleasantries.  “What happened the other night?”

Pamela felt her mouth go dry and looked hopefully at the pitcher of water Amanda kept on her desk.  Dr. Blake poured her a glass and nodded for her to continue.  Talking to Dr. Blake proved to be more difficult than the nurse would have liked.  She felt as if she was being dissected as she recounted the events to the best of her ability of how she had found Samantha sitting on the floor with a pair of scissors and cutting her hair.

“You said you saw bald spots?”

Pamela nodded.  “It looked like she may have been doing it for a while, but recently.  I saw patches of her scalp.”

Amanda sat back in her chair feeling puzzled.  She tapped her pencil’s eraser against her desk.  “Did she say anything?”

The nurse's eyes lit up as she nodded.  “Yes.  When I asked her if she was alright, she said something about how her uncle had to check to make sure she wasn’t a dirty whore like her mother.”  Pamela then told her about how Samantha had pointed the tip of the scissors towards her body and down towards her crotch where she made a circle.  Her voice was faint.  “It was odd.  Like she was having a flashback.”

For the next two hours, Pamela continued to talk about the incident and answer Amanda’s questions as well as she could.  Dr. Blake did not look up as she fired her questions.  Her hand seemed to fly over the pad of paper she hadn’t noticed on her desk.  “That will be all, Pamela,” she said.  “Thank you.”

When she finished going over her notes and comparing them to Samantha’s chart it was after 11:00.  She rubbed her eyes.  The strain over the last nine hours made her brain hurt.  “I can do this,” she mumbled.  She imagined Dr. Wilson sneering, ‘We knew you couldn’t do it,’ as she picked up the phone.  Her hand trembled over the buttons as she called home.  Daniel picked up after the ninth ring.

“Hello?”

“I’m sorry to wake, you Daniel.”

Daniel was surprised to hear Amanda’s voice on the other end of the line and looked at his watch.  “It’s after 11:00, Amanda.  Where are you?”

“At Sanford.  I told you this afternoon something came up.”

Her tone was neutral, bordering void, making Daniel think one of the patients had tried to do something like wash his or her bedding in a toilet.  He masked the idea with a fake cough and hoped she wouldn’t be able to tell he was trying hard not to laugh.  “I know.  I just thought you’d be home by now.”

Amanda hesitated.  She was tempted to tell him she would be staying the night in her office.  “I need a drink.”

The momentary silence was thick between them.  “I’ll open the Hennessy.  How long do you think it’ll be before you get here?”

“I should be there before twelve.”

“Alright, Amanda.  If you’re not back by then, I’ll come and get you.”

Amanda’s dismissive gesture was automatic as she answered with her usual air of authority.  “That won’t be necessary.”

She dropped the phone in its cradle and looked at the pile of paper on her desk.  She would put Samantha’s chart back together the next time she was in.  She switched off her lamp and then fished through the middle drawer for her wallet and keys.  After she locked the door to her office, she went to check on Samantha.

The strong smell of ammonia burned her nose as she made her way to Samantha’s room.  She made a mental note to take an inventory of the cleaning supplies to see what was being used and what alternatives were available.  The rubber soles of her sensible shoes gave off a brisk squeak as she walked down the hallway.  As she approached the doorway of her destination, she spied Nurse Horscham making rounds.  “Have you been in to see her?”

Pamela nodded.  “She seems stable.  The restraints are just precautionary at this point.  Other than that, there’s nothing to report.”

“Good.  Please continue.”

The nurse nodded and hurried away as softly as possible, feeling the medical director’s eyes boring into the back of her skull.  Amanda waited until Pamela was out of sight then entered Samantha’s room.  The other two patients she shared space with were asleep.  Amanda spied a small locker by the woman’s bed secured with a combination lock. “Hmm,” she mumbled.  She bent down and turned the cold, security device over as if expecting to find the code to unlock it on the back and mocked her as it clanged against the metal door when she released it.

Amanda straightened and turned to face the bed.  Samantha’s eyes were in a wide-open state of blank awareness.  She had drifted into some unknown place where only she could go.  Even though comfort was not a typical characteristic of Amanda's, she placed a gentle hand on her forehead, mindful of the bandage.  “Get some sleep, Samantha.”

Samantha’s eyes snapped shut with childlike obedience.  Amanda tilted her head from side to side and tried to get a good view of the damage she had done.  To Pamela’s credit, what Dr. Blake saw matched the nurse’s story.  She pulled her hand away and left the building.